title: Hardiness, depression, and emotional well-being and their association with appetite in older adults.
abstract: OBJECTIVE
  To examine the associations between hardiness (defined as the ability to manage stress), depression, and emotional well-being and appetite in older adults.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Assisted-living facilities and senior centers in the Washington/Baltimore area.
  
  
  METHODS
  Two hundred ninety-two adults aged 60 and older.
  
  
  METHODS
  Depressive symptoms assessed using the 5-item Geriatric Depression Scale and categorized as 0 to 1 (normal, referent group) versus 2 to 5 (depressive symptoms present). Hardiness was measured using the 18-item Dispositional Resilience Scale II modified based on interviews with older adults and categorized as 67 or less (low hardiness) versus greater than 67 (normal, referent group). Appetite was measured using the Simplified Nutritional Appetite Questionnaire and categorized as 4 to 14 (poor appetite) versus 15 to 20 (normal, referent group). Emotional well-being was measured using a single question.
  
  
  RESULTS
  Depression, hardiness, and emotional well-being were all significantly associated with appetite. In models controlling for confounders (data collection site, age, educational attainment, self-reported health, race, presence of chronic disease), fair to poor emotional well-being was most significantly associated with poor appetite (odds ratio (OR)=5.60, 95% confidence interval (CI)=2.60-12.07) and low commitment (a component of hardiness that indicates an individual's involvement in life) was also significantly associated with poor appetite (OR=1.35, 95% CI=1.13-1.61).
  
  
  CONCLUSIONS
  These associations further elucidate the components of mental health that contribute to poor appetite in this population. Simple measures of self-reported mental health administered to older adults may predict poor appetite and lend themselves to potential interventions to prevent malnutrition and negative health outcomes.
authors.affiliation: Department of Nutrition and Food Science, University of Maryland, College Park, Maryland, USA.
authors.forename: Julia H
authors.initials: JH
authors.lastname: Engel
authors.forename: Frank
authors.initials: F
authors.lastname: Siewerdt
authors.forename: Robert
authors.initials: R
authors.lastname: Jackson
authors.forename: Ucheoma
authors.initials: U
authors.lastname: Akobundu
authors.forename: Carolyn
authors.initials: C
authors.lastname: Wait
authors.forename: Nadine
authors.initials: N
authors.lastname: Sahyoun
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged / Q000523:psychology*; D000369:Aged, 80 and over; D001066:Appetite; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D004644:Emotions; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors